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Implant Exchange: Reasons, Procedure & Risks

An implant exchange is a surgical procedure in which an existing medical implant is removed and replaced with a new one.

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Things worth knowing about "Implant exchange"

An implant exchange is a surgical procedure in which an existing medical implant is removed and replaced with a new one.

What is an implant exchange?

An implant exchange is a surgical procedure in which an existing medical implant – such as a breast implant, a joint prosthesis, or a cardiac pacemaker – is removed and replaced with a new or equivalent implant. The procedure may be necessary for medical reasons or may be performed at the request of the patient.

Reasons for an implant exchange

There are various reasons why an implant exchange may be required:

Wear and material fatigue: Implants have a limited lifespan and must be replaced after a certain period of time.
Complications: Capsular contracture (hardening of the tissue surrounding the implant), implant rupture, or displacement can make a replacement necessary.
Infections: An infection around the implant often requires its removal and subsequent replacement.
Changes in health status: Changes in physical condition or new medical findings may make a replacement advisable.
Product recall: If a specific implant type is recalled by the manufacturer, a prophylactic exchange may be indicated.
Patient preference: Particularly with aesthetic implants (e.g., breast implants), a patient may wish to change the size or shape.

Types of implants that can be exchanged

An implant exchange can be performed for various implant types:

Breast implants: Often after 10 to 15 years or in cases of complications such as capsular contracture or rupture.
Joint prostheses (hip, knee, shoulder): After significant wear or loosening of the implant, also referred to as revision arthroplasty.
Pacemakers and defibrillators: Replacement when the battery is depleted or in the event of a technical defect.
Dental implants: In cases of implant failure or changes in the jawbone.
Intraocular lenses: In cases of inadequate vision correction or complications following cataract surgery.

Procedure of an implant exchange

The exact procedure depends largely on the type of implant and its location. In general, the procedure involves the following steps:

Preoperative diagnostics: Imaging procedures such as ultrasound, MRI, or X-ray to assess the existing implant and surrounding tissue.
Anesthesia: Local or general anesthesia depending on the type of procedure.
Removal of the old implant: Surgical exposure and removal of the existing implant.
Insertion of the new implant: Placement of the replacement implant in the prepared implant site.
Wound closure and follow-up care: Closure of the surgical wound and regular check-ups during the healing phase.

Risks and possible complications

Like any surgical procedure, an implant exchange carries certain risks:

Infection of the surgical wound
Post-operative bleeding or hematomas
Scarring of the surrounding tissue
Recurrent capsular contracture (with breast implants)
Loosening or malposition of the new implant
Reactions to anesthetics or implant materials

Follow-up care and healing

Post-operative care following an implant exchange varies individually and depends on the type of implant. In general, regular follow-up examinations are essential to monitor the healing process and respond promptly to any complications. For joint prostheses, physiotherapeutic support is often necessary. Patients should inform their doctor about any symptoms that arise after the procedure.

References

Deutsche Gesellschaft für Plastische, Rekonstruktive und Ästhetische Chirurgie (DGPRÄC) – Guidelines on Breast Surgery, 2022.
Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU) – Guideline on Total Hip Arthroplasty, 2023.
European Commission – Regulation (EU) 2017/745 on Medical Devices (MDR), 2017.

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